Elementary students take fresh approach to healthier hearts

November 17, 1992|By Jonathan Bor | Jonathan Bor,Staff Writer

Two years of cutting fried foods, eating green vegetables and substituting fruit for fatty desserts has helped a group of East Baltimore children lower their cholesterol and blood pressure -- and, possibly, their risk of heart attack when they grow older.

Dr. Kerry J. Stewart, who designed an educational program for third- and fourth-graders at 12 elementary schools, reported yesterday that the youngsters cut their blood cholesterol levels about 7 percent -- from an average of 162 milligrams per deciliter to 149 milligrams.

"We used relatively inexpensive educational techniques through a school system to get kids to make changes that enabled them to lower blood pressure and lower cholesterol," said Dr. Stewart, director of the cardiac rehabilitation and prevention programs at the Francis Scott Key Medical Center.

He presented his findings yesterday at the annual scientific sessions of the American Heart Association in New Orleans.

While he could not predict exactly the long-range effects on the children's health, the study dovetails with recent findings that clogged arteries have their roots in childhood.

A Louisiana study, for instance, found the beginnings of plaque formation in the arteries of children with high levels of cholesterol in their bloodstream. These are the same fatty plaques that can cause heart attacks when they thicken to the point of blocking normal blood flow.

"Also, there is certainly evidence in the literature that people who have low cholesterol generally tend to have lower rates of heart disease," Dr. Stewart said. "And there's evidence that cholesterol levels in children tend to track. Those who have high levels as kids tend to have high levels as adults."

In the Baltimore study, children learned how to eliminate fats from their favorite fast-food meals; how to add fruits and vegetables to their diet; and how to calculate the percentage of fat in their diet. And in a larger sense, they learned the connections between diet and health.

Rather than insisting upon radical changes in diet, the research staff taught the children to make more subtle shifts in their diet -- limiting rather than eliminating trips to fast-food restaurants, and moving to low-fat snacks like pretzels rather than shunning snack foods altogether.

While 700 children received the nutrition education, the researchers took cholesterol and blood pressure readings from about 300 children. The program has cost about $100,000 a year.

Data from last year -- the third year in the study -- is incomplete, but Dr. Stewart said he has observed a continued downward trend in the cholesterol levels. The trend has continued despite a tendency for the levels to increase slightly during the summer months when the children were out of school.

Systolic blood pressure, the maximum pressure inside the arteries when the heart contracts, fell by an average of 5 points over two years. Diastolic blood pressure actually rose slightly, but Dr. Stewart said the increase was not enough to bring about any changes in blood flow.

"We believe if we can drive these levels down, that should translate into a reduction in heart diseases when these kids become adults, although there's no definitive study that has proven that yet."

In another study, grade-school children in North Carolina achieved similar results through a program that combined physical exercise and nutrition education for a period of eight weeks. The program, run by the University of North Carolina School of Nursing in Chapel Hill, was given to 600 third- and fourth-graders at six rural and six urban elementary schools.

At the end of eight weeks, the average decline in blood cholesterol was 6.8 milligrams per deciliter.